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Intravitreal brolucizumab as treatment of early onset radiation retinopathy secondary to plaque brachytherapy for choroidal melanoma.

Publication ,  Journal Article
Villegas, NC; Mishra, K; Steinle, N; Liu, W; Beadle, B; Mruthyunjaya, P
Published in: Am J Ophthalmol Case Rep
September 2022

PURPOSE: To describe the efficacy and safety of brolucizumab (Beovu®, Novartis Pharmaceuticals) in a case of cystoid macular edema associated with radiation retinopathy as a result of iodine-125 plaque brachytherapy (PBT) for choroidal melanoma, resistant to treatment with other anti-vascular endothelial growth factor (VEGF) agents. OBSERVATIONS: A 67-year-old woman with choroidal melanoma in the right eye and best-corrected visual acuity (BCVA) of 20/20, underwent uncomplicated PBT. On post-operative month 7, the patient developed early onset radiation retinopathy. She failed to improve significantly with sub-tenon triamcinolone and 3 injections of intravitreal bevacizumab; BCVA was 20/200. Intravitreal brolucizumab was administered, and one month after, macular edema had resolved completely on optical coherence tomography, and BCVA improved to 20/50. At last follow up, 1 month after the third brolucizumab injection, BCVA was 20/60 and there was sustained resolution of intraretinal fluid. There were no signs of intraocular inflammation, progressive RR or optic neuropathy on exam or fluorescein angiography. CONCLUSIONS: This case suggests a positive effect of brolucizumab in the management of radiation retinopathy following PBT refractory to other anti-VEGF agents. However, one must consider the risk of severe vision loss associated with retinal vasculitis from use of brolucizumab.

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Published In

Am J Ophthalmol Case Rep

DOI

EISSN

2451-9936

Publication Date

September 2022

Volume

27

Start / End Page

101581

Location

United States
 

Citation

APA
Chicago
ICMJE
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Villegas, N. C., Mishra, K., Steinle, N., Liu, W., Beadle, B., & Mruthyunjaya, P. (2022). Intravitreal brolucizumab as treatment of early onset radiation retinopathy secondary to plaque brachytherapy for choroidal melanoma. Am J Ophthalmol Case Rep, 27, 101581. https://doi.org/10.1016/j.ajoc.2022.101581
Villegas, Natacha C., Kapil Mishra, Nathan Steinle, Wu Liu, Beth Beadle, and Prithvi Mruthyunjaya. “Intravitreal brolucizumab as treatment of early onset radiation retinopathy secondary to plaque brachytherapy for choroidal melanoma.Am J Ophthalmol Case Rep 27 (September 2022): 101581. https://doi.org/10.1016/j.ajoc.2022.101581.
Villegas NC, Mishra K, Steinle N, Liu W, Beadle B, Mruthyunjaya P. Intravitreal brolucizumab as treatment of early onset radiation retinopathy secondary to plaque brachytherapy for choroidal melanoma. Am J Ophthalmol Case Rep. 2022 Sep;27:101581.
Villegas, Natacha C., et al. “Intravitreal brolucizumab as treatment of early onset radiation retinopathy secondary to plaque brachytherapy for choroidal melanoma.Am J Ophthalmol Case Rep, vol. 27, Sept. 2022, p. 101581. Pubmed, doi:10.1016/j.ajoc.2022.101581.
Villegas NC, Mishra K, Steinle N, Liu W, Beadle B, Mruthyunjaya P. Intravitreal brolucizumab as treatment of early onset radiation retinopathy secondary to plaque brachytherapy for choroidal melanoma. Am J Ophthalmol Case Rep. 2022 Sep;27:101581.
Journal cover image

Published In

Am J Ophthalmol Case Rep

DOI

EISSN

2451-9936

Publication Date

September 2022

Volume

27

Start / End Page

101581

Location

United States